...But Can't Attract U.S. Students

I would like to address a serious problem that has immediate and long-range consequences for biomedical education, the medical profession, and community health in general. It concerns, specifically, the alarming decrease in the number of young people seeking careers in biomedical research, medicine, and allied health professions. According to statistics compiled by the Association of American Medical Colleges, the number of college students taking the Medical College Aptitude Test (MCAT) has decreased precipitously, and the mean score of those students taking the exam continues to decline. The situation for graduate students entering Ph.D. programs is even more grim. It is obvious that bright young people today are not interested in careers in the health field—either as practicing physicians, academicians, or research scientists. Word is out that careers in the health field are not desirable, whether in terms of prestige, job, security, or financial reward. Why is this? One reason is obviously the high cost of medical education. After graduation, medical students enter internship and residency programs owing almost $50,000 at public institutions and twice as much at private schools. And after passing specialty boards in orthopedic surgery, for example, the new surgeon will require malpractice insurance which, on average, costs about $70,000 per year. In many teaching hospitals, the cost of malpractice insurance has increased twentyfold in the past four or five years! Clearly, the atmosphere for practicing medicine with compassion does not exist except for the very unusual individual. What of the prospects for young Ph.D.’s in the biomedical field? These are even less attractive. Training grants for graduate studies today are few in number and not easily obtained. Support for biomedical research is based largely on funds derived from NIH grants, but in recent years financial constraints have dictated that more than two-thirds of the grants approved by peer review committees have not been funded. Even having a funded grant does not always guarantee two to three years of fiscal stability; severe cuts in funding are being made continually during "non-competitive" renewal years. Though the new budget for FY 1990, as proposed by the Bush administration, will increase the dollar amount available for NIH awards, it promotes the continuation of a destructive process, since the number of new and competing grants is slated to decline. Thus, the nation’s best minds, so essential to the success of biomedical research, are turning to other, more stable and financially promising fields. Clearly, another approach must be used in apportioning funds to the NIH. Consider first that the total cost of health care, including everything from over-the-counter drugs to in hospital procedures, is over $500 billion annually. Congress should have a formula for funding based on percentages of our spending against sickness and disease—that is, a percentage of this enormous expenditure should be plowed back into research and development. It should be easier to “sell” R&D funding to both the taxpayer and Congress in these terms than, for example, in terms of the number of grants that should be funded in the next fiscal year. A by-product of this investment in R&D, based on health costs, is clearly the boost it would give to our economy. Not only does money for health and health care employ people in both the private and public sectors of our nation, but the advances in biology and medicine have contributed significantly to the financial health and growth of chemical, pharmaceutical, and the new biotechnology industries. Those of us in the scientific arena know that R&D is cost-effective. That data (with specific examples) should be made available to the general public and to Congress. More information needs to be made available to the media on the progress that has been made in cancer, cardiovascular disorders, and other major health concerns as a result of the growth of the biomedical research community through NIH funding. Articles should be written in newspapers not only about the future of AIDS vaccines, for example, but also, more importantly, the necessity of funding for basic immunobiologic research, which is the main route to new scientific breakthroughs. We should have learned from the anticancer campaign that you can’t throw money at a problem and expect it to vanish. These diseases are very complex and require long-term support of scholarly research in the biomedical enterprise. Everyone has anguished over the death of their loved ones caused by our lack of knowledge in the biomedical field. Is the taxpayer aware that less than 1% of the federal budget is alotted to the NIH? We must make a concerted effort to convince the public and legislators as to the value of basic research and help make more money available for funding, so that we will attract the best young minds to help us in our battle. George D. Pappas is head of the Department of Anatomy and Cell Biology at the University of Illinois College of Medicine at Chicago.

...But Can't Attract U.S. Students

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